Department of Pediatrics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, CZ-15006 Prague, Czech Republic.
Department of Pediatrics, University Hospital Brno, CZ-62500 Brno, Czech Republic.
Nutrients. 2021 Oct 30;13(11):3903. doi: 10.3390/nu13113903.
AIMS/HYPOTHESIS: The proportion of children with type 1 diabetes (T1D) who have experience with low-carbohydrate diet (LCD) is unknown. Our goal was to map the frequency of LCD among children with T1D and to describe their clinical and laboratory data.
Caregivers of 1040 children with T1D from three centers were addressed with a structured questionnaire regarding the children's carbohydrate intake and experience with LCD (daily energy intake from carbohydrates below 26% of age-recommended values). The subjects currently on LCD were compared to a group of non-LCD respondents matched to age, T1D duration, sex, type and center of treatment.
A total of 624/1040 (60%) of the subjects completed the survey. A total of 242/624 (39%) subjects reported experience with voluntary carbohydrate restriction with 36/624 (5.8%) subjects currently following the LCD. The LCD group had similar HbA1c (45 vs. 49.5, = 0.11), lower average glycemia (7.0 vs. 7.9, = 0.02), higher time in range (74 vs. 67%, = 0.02), lower time in hyperglycemia >10 mmol/L (17 vs. 20%, = 0.04), tendency to more time in hypoglycemia <3.9 mmol/L(8 vs. 5%, = 0.05) and lower systolic blood pressure percentile (43 vs. 74, = 0.03). The groups did not differ in their lipid profile nor in current body height, weight or BMI. The LCD was mostly initiated by the parents or the subjects themselves and only 39% of the families consulted their decision with the diabetologist.
CONCLUSIONS/INTERPRETATION: Low carbohydrate diet is not scarce in children with T1D and is associated with modestly better disease control. At the same time, caution should be applied as it showed a tendency toward more frequent hypoglycemia.
目的/假设：患有 1 型糖尿病（T1D）的儿童使用低碳水化合物饮食（LCD）的比例尚不清楚。我们的目标是绘制 T1D 患儿中 LCD 的频率，并描述其临床和实验室数据。
向来自三个中心的 1040 名 T1D 患儿的照料者发送了一份结构化问卷，内容涉及儿童的碳水化合物摄入量和 LCD 体验（年龄推荐值的碳水化合物每日能量摄入量低于 26%）。目前正在使用 LCD 的受试者与一组非 LCD 应答者进行了比较，这些应答者在年龄、T1D 持续时间、性别、类型和治疗中心方面相匹配。
共有 1040 名受试者中的 624 名（60%）完成了调查。共有 242/624（39%）名受试者报告有自愿限制碳水化合物摄入的经验，其中 36/624（5.8%）名受试者目前遵循 LCD。LCD 组的 HbA1c 相似（45 与 49.5，=0.11），平均血糖水平较低（7.0 与 7.9，=0.02），时间在目标范围内较高（74 与 67%，=0.02），时间在高血糖 >10mmol/L 较低（17 与 20%，=0.04），倾向于时间在低血糖 <3.9mmol/L 较长（8 与 5%，=0.05），收缩压百分位数较低（43 与 74，=0.03）。两组在血脂谱或当前身高、体重或 BMI 方面没有差异。LCD 主要由父母或患儿本身启动，只有 39%的家庭在决定时咨询了糖尿病医生。
结论/解释：低碳水化合物饮食在 T1D 患儿中并不罕见，并且与疾病控制的适度改善有关。同时，应谨慎应用，因为它显示出更频繁发生低血糖的趋势。
